2019-20 CCLC Mentor Form

2020-21 CCLC Mentor Form

The mission of the Catholic Charities Atlanta Leadership Program is to help Catholic men and women grow spiritually and professionally as servant leaders through educational events, service opportunities, networking, mentoring and fundraising with Catholic Charities Atlanta.
Salutation
Name *

First Name Last Name
Job Title
Company Name
Company Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Preferred Phone *

Area Code Phone Number
LinkedIn
Twitter
Facebook
What parish or church do you attend?
What is the name of your spouse?
Why do you feel you would be a good mentor for a Leadership Class candidate?
Describe yourself using FIVE adjectives or phrases.
Describe your interests outside of work.
Describe your family life.
Describe your ideal mentee.
In which areas do you believe you could best mentor someone? Check all that apply.

Engaging in the Church Integrating Faith and Work Experience of Being Catholic in a Secular World Servant Leadership Work/Life Balance Managing/Developing People Building Executive Presence Influencing Others Corporate Politics/Corporate Culture Personal Spiritual Path Networking Other
If you picked "Other" above, please describe.
Please list professional, social, and charitable organizations that you are invloved in. (This information will help us match you with a mentee of similar interests.)
Please write or include a short bio to be included in class materials. (We are happy to write one for you if you would just list specific bulleted pieces of information that you would like us to include.)
*Disclaimer
The mentee is responsible for driving your partnership, but it is important that you make a commitment of your time to your mentee.

Please check YES below if you are will to commit to meeting with your mentee one hour per month.
I agree to and understand the terms of this program. *

Yes
Signature date *
Signature *
Should be Empty:

2020-21 CCLC Mentor Form